NORTH MEMORIAL FOUNDATION: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
NORTH MEMORIAL FOUNDATION (EIN 41-1777966)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-15
IRS object ID
201933199349302593
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-15T08:28:11-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY VIRCHOW KRAUSE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1225 S 6TH ST 2300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411777966EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTH MEMORIAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt
Phone7635205200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVENUE NORTHAddressLine1Txt
CityROBBINSDALECityNm
State AbbreviationMNStateAbbreviationCd
ZIP554222900ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKENT SPAULDINGPersonNm
Person TitleVP FOUNDATIONPersonTitleTxt
Phone7635205200PhoneNum
Signature2019-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLAWRENCE H MOHR CPAPreparerPersonNm
PTINP00447603PTIN
Phone6128764500PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address38.88.188.75IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-14IPDt
IP Tm11:01:40IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id42991B41A32A13F77B110C5B470B2D73D8292482AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-04-17 16:48:07ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKENT SPAULDINGPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVENUE NORTHAddressLine1Txt
CityROBBINSDALECityNm
State AbbreviationMNStateAbbreviationCd
ZIP554222900ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,940,772GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.NORTHMEMORIAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO SUPPORT NORTH MEMORIAL HEALTH CARE AND ITS COMMITMENT TO CHANGING AND SAVING LIVES. THROUGH PHILANTHROPY, OUR DONORS ASSIST IN GIVING OUR PATIENTS AND THEIR FAMILIES COMPASSIONATE, REMARKABLE CARE.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers150TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$787,759PYContributionsGrantsAmt
CY Contributions Grants$692,238CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income-$32,147PYInvestmentIncomeAmt
CY Investment Income$209,046CYInvestmentIncomeAmt
PY Other Revenue$78,409PYOtherRevenueAmt
CY Other Revenue$128,116CYOtherRevenueAmt
PY Total Revenue$834,021PYTotalRevenueAmt
CY Total Revenue$1,029,400CYTotalRevenueAmt
PY Grants And Similar Paid$387,752PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$394,163CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$40,295PYOtherExpensesAmt
CY Other Expenses$282,633CYOtherExpensesAmt
PY Total Expenses$428,047PYTotalExpensesAmt
CY Total Expenses$676,796CYTotalExpensesAmt
PY Revenues Less Expenses$405,974PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$352,604CYRevenuesLessExpensesAmt
Total Assets BOY$8,905,755TotalAssetsBOYAmt
Total Assets EOY$8,408,067TotalAssetsEOYAmt
Total Liabilities BOY$45,642TotalLiabilitiesBOYAmt
Total Liabilities EOY$21,989TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$8,860,113NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,386,078NetAssetsOrFundBalancesEOYAmt
MissionTO SUPPORT NORTH MEMORIAL HEALTH CARE AND ITS COMMITMENT TO CHANGING AND SAVING LIVES. THROUGH PHILANTHROPY, OUR DONORS ASSIST IN GIVING OUR PATIENTS AND THEIR FAMILIES COMPASSIONATE, REMARKABLE CARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$14,105ExpenseAmt
Grant$14,105GrantAmt
DescCANCER CARE:FOUNDATION FUNDS IN 2018 HELPED IMPROVE CUSTOMER CARE, UPDATE TREATMENT FACILITIES AND EXPAND THE SERVICES PROVIDED. FINANCIAL SUPPORT ALLOWS US TO PAY FOR PHARMACEUTICAL TREATMENTS FOR INDIVIDUALS STRUGGLING TO AFFORD CARE THEY NEED TO GET BETTER OR MANAGE THEIR PAIN, PROVIDE ACCESS TO ADVANCED TECHNOLOGIES THAT ALLOW US TO TREAT PATIENTS MORE QUICKLY AND MORE EFFECTIVELY, SUPPORT FACILITY RENOVATIONS AND PURCHASE NEW EQUIPMENT TO IMPROVE TREATMENT ENVIRONMENTS SO WE CAN PROVIDE TREATMENTS MORE COMFORTABLY AND WITH LESS PAIN AND DELIVER EDUCATIONAL PROGRAMMING AND MATERIALS, AS WELL AS CANCER SCREENING SERVICES, TO VULNERABLE, UNDERSERVED COMMUNITIES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$45,042ExpenseAmt
Grant$45,042GrantAmt
DescTEAM MEMBER CRISIS FUND:FOUNDATION FUNDS IN 2018 DEDICATED TO THE NORTH MEMORIAL HEALTH TEAM MEMBER CRISIS FUND HELPED PROVIDE FINANCIAL ASSISTANCE TO CURRENT TEAM MEMBERS IN GOOD STANDING. THESE DOLLARS HELP TEAM MEMBERS QUICKLY WHEN SERIOUS HEALTH CONDITIONS, INJURIES, NEW OR UNANTICIPATED MEDICATIONS COSTS, CATASTROPHIC EVENTS OR OTHER HARDSHIPS OCCUR THAT HINDER TEAM MEMBERS FROM BEING ABLE TO AFFORD THE COST OF EMERGENT OR BASIC LIVING EXPENSES. THE FUND IS INTENDED TO HELP IN A TIME OF NEED AND IS NOT INTENDED TO MAKE THE INCURRED LOSS WHOLE FOR THE INDIVIDUAL.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$510,593ExpenseAmt
Grant$335,016GrantAmt
DescPROGRAM, SERVICE AND OPERATIONAL SUPPORT FOR NORTH MEMORIAL HEALTH:THE FOUNDATION DEDICATES ITSELF TO RAISING MONEY TO SUPPORT THE HEALTH OF THE ENTIRE COMMUNITY SERVED BY NORTH MEMORIAL HEALTH. THE FOUNDATION HELPS CLOSE THE GAP BETWEEN THE SERVICES PROVIDED BY THE HEALTH CARE SYSTEM AND THE COMPENSATION RECEIVED FROM CUSTOMER PAYMENTS, INSURANCE AND THE GOVERNMENT. DONOR SUPPORT HELPS IMPROVEMENTS THAT WOULD LIKELY NOT OTHERWISE BE POSSIBLE, MAKING US A STRONG, RESPONSIVE AND ACCESSIBLE COMMUNITY RESOURCE. DONATIONS HELP IMPROVE CUSTOMER EXPERIENCE, MODERNIZE FACILITIES, BROADEN PROGRAMS AND SERVICES, SUPPORT COMMUNITY PARTNERSHIPS, PROVIDE ACCESS TO SPECIALIZED MEDICAL EQUIPMENT AND NEW TECHNOLOGIES.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$569,740TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised FundYes (1)DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document12IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AARON BLOOMQUISTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7635205200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVENUE NORTHAddressLine1Txt
CityROBBINSDALECityNm
State AbbreviationMNStateAbbreviationCd
ZIP554222900ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
J KEVIN CROSTON MD
BOARD MEMBER1.0052.00Yes (X)$0$1,020,962$46,962
BRUCE QUAM
BOARD CHAIR1.000.00Yes (X)$0$0$0Yes (X)
MICHAEL STEINHAUSER
SECRETARY1.002.00Yes (X)$0$10,000$0Yes (X)
JANDEEN BOONE
BOARD MEMBER1.000.00Yes (X)$0$0$0
CHENG LOR
BOARD MEMBER1.000.00Yes (X)$0$0$0
JIM BYRNE
BOARD MEMBER1.000.00Yes (X)$0$0$0
MARK NIBLICK
BOARD MEMBER1.000.00Yes (X)$0$0$0
DIANE NILSON
BOARD MEMBER1.000.00Yes (X)$0$0$0
PAMELA DOORENBOS MD
BOARD MEMBER1.0050.00Yes (X)$0$346,284$25,501
SCOTT HEMENWAY
BOARD MEMBER1.000.00Yes (X)$0$0$0
TROY REDING
BOARD MEMBER1.000.00Yes (X)$0$0$0
MICHAEL HOLTZ
BOARD MEMBER1.000.00Yes (X)$0$0$0
DEEPAK KADEMANI DMD MD
BOARD MEMBER1.0050.00Yes (X)$0$684,540$45,591
BRIAN BRUGGEMAN
BOARD MEMBER1.000.00Yes (X)$0$0$0
BETH MEJIA
BOARD MEMBER1.000.00Yes (X)$0$0$0
ERIC SKALLAND
BOARD MEMBER1.000.00Yes (X)$0$0$0
KENT SPAULDING
VICE PRESIDENT1.0050.00$0$259,354$39,640Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,321,140TotReportableCompRltdOrgAmt
Total Other Compensation$157,694TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$355,576FundraisingAmt
All Other Contributions$336,662AllOtherContributionsAmt
Noncash Contributions$110,786NoncashContributionsAmt
Total Contributions$692,238TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$182,305TotalRevenueColumnAmt
Exclusion$182,305ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$724,451SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$697,710SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$26,741SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$26,741TotalRevenueColumnAmt
Exclusion$26,741ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$341,778FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$355,576ContriRptFundraisingEventAmt
Fundraising Direct Expenses$213,662FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$128,116TotalRevenueColumnAmt
Exclusion$128,116ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,029,400TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$337,162ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$252,543TotalAmt
Program Services$252,543ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$141,620TotalAmt
Program Services$141,620ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,946TotalAmt
Management And General$2,946ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$10,534TotalAmt
Program Services$10,534ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
OUTSIDE SERVICES$133,779$79,778$54,001
SUPPLIES$82,189$32,080$50,109
EQUIPMENT AND REPAIRS$53,185$53,185

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$676,796TotalAmt
Program Services$569,740ProgramServicesAmt
Management And General$107,056ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$281,281BOYAmt
EOY$310,465EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$58,545BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$15,758BOYAmt
EOY$9,983EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$7,474,474BOYAmt
EOY$7,592,689EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,075,697BOYAmt
EOY$494,930EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$8,905,755BOYAmt
EOY$8,408,067EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$19,623BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$26,019BOYAmt
EOY$21,989EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$45,642BOYAmt
EOY$21,989EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,265,772BOYAmt
EOY$2,091,762EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,199,485BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,394,856BOYAmt
EOY$6,294,316EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,860,113BOYAmt
EOY$8,386,078EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,905,755BOYAmt
EOY$8,408,067EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$352,604ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$540,012NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$286,627OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,649,575CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,464,107CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,574,758CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$787,759CurrentTaxYearMinus1YearAmt
Current Tax Year$692,238CurrentTaxYearAmt
Total$6,168,437TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,649,575CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,464,107CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,574,758CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$787,759CurrentTaxYearMinus1YearAmt
Current Tax Year$692,238CurrentTaxYearAmt
Total$6,168,437TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$6,168,437PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$125,014CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$122,845CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$99,819CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$145,775CurrentTaxYearMinus1YearAmt
Current Tax Year$182,305CurrentTaxYearAmt
Total$675,758TotalAmt
FieldValueIRS element (for citing)
Total Support$6,844,195TotalSupportAmt
Public Support CY1700.90130PublicSupportCY170Pct
Public Support PY1700.92560PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Donor Advised Funds Held3DonorAdvisedFundsHeldCnt
Donor Advised Funds Contri$1,840DonorAdvisedFundsContriAmt
Donor Advised Funds Grants$5,893DonorAdvisedFundsGrantsAmt
Donor Advised Funds Vl EOY$21,966DonorAdvisedFundsVlEOYAmt
Disclosed Org Leg CtrlYes (1)DisclosedOrgLegCtrlInd
Disclosed For Charitable PrpsYes (1)DisclosedForCharitablePrpsInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,344,063BeginningYearBalanceAmt
Contributions$82,062ContributionsAmt
Investment Earnings Or Losses-$75,671InvestmentEarningsOrLossesAmt
Other Expenditures$414,300OtherExpendituresAmt
Administrative Expenses$16,500AdministrativeExpensesAmt
End Year Balance$2,919,654EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,029,196BeginningYearBalanceAmt
Investment Earnings Or Losses$370,959InvestmentEarningsOrLossesAmt
Other Expenditures$56,092OtherExpendituresAmt
End Year Balance$3,344,063EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,203,143BeginningYearBalanceAmt
Contributions$155,228ContributionsAmt
Investment Earnings Or Losses$707,969InvestmentEarningsOrLossesAmt
Other Expenditures$37,144OtherExpendituresAmt
End Year Balance$3,029,196EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,591,423BeginningYearBalanceAmt
Investment Earnings Or Losses$17,322InvestmentEarningsOrLossesAmt
Other Expenditures$1,405,602OtherExpendituresAmt
End Year Balance$2,203,143EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,446,092BeginningYearBalanceAmt
Contributions$76,703ContributionsAmt
Investment Earnings Or Losses$118,858InvestmentEarningsOrLossesAmt
Other Expenditures$50,230OtherExpendituresAmt
End Year Balance$3,591,423EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.72210PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.27790TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescBENEFICIAL INTEREST IN REMAINDER TRUSTDesc
Book Value$494,930BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$494,930TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescAMOUNTS HELD FOR OTHERSDesc
Amt$21,989Amt
FieldValueIRS element (for citing)
Total Liability$21,989TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:1) RALPH ROSSEN ENDOWMENT: THIS ENDOWMENT WAS ESTABLISHED IN 1986 TO PROVIDE RECOGNITION TO NURSING STAFF THAT PROVIDE REMARKABLE SERVICE TO NORTH MEMORIAL PATIENTS AND THEIR FAMILIES. MEMBERS OF THE ROSSEN FAMILY SERVE ON A COMMITTEE ALONG WITH THE VP AND CHIEF NURSING OFFICER OF NORTH MEMORIAL TO SELECT THE RECIPIENTS. 2) HAROLD B. KAISER HONORARY LECTURESHIP ENDOWMENT: DR KAISER IS THE FOUNDER OF ALLERGY & ASTHMA SPECIALISTS, P.A. ESTABLISHED IN 1966. THE HAROLD B KAISER HONORARY LECTURESHIP ENDOWMENT PROVIDES FUNDING FOR A KEYNOTE SPEAKER FOR THE ANNUAL ALLERGY & ASTHMA CONFERENCE HELD IN THE MINNEAPOLIS AREA IN MARCH. 3) HAROLD ECKER ENDOWMENT: ESTABLISHED IN 1994 IN HONOR OF THE EXCELLENT CARE THAT MR. ECKER RECEIVED AS A PATIENT AT NORTH MEMORIAL, THE HAROLD ECKER ENDOWMENT PROVIDES A $500 AWARD TO THREE NORTH MEMORIAL EMPLOYEES RECOGNIZING THEIR OUTSTANDING PERFORMANCE AND PERSONAL ATTITUDE. THE AWARD IS OPENED TO ALL EMPLOYEES AND THE WINNERS ARE SELECTED BY A COMMITTEE OF NORTH MEMORIAL EMPLOYEES AND PRESENTED AT THE ANNUAL QUALITY AWARDS LUNCHEON IN NOVEMBER EACH YEAR. 4) RESIDENTIAL HOSPICE ENDOWMENT: THE RESIDENTIAL HOSPICE ENDOWMENT WAS ESTABLISHED BY DR. JOHN AND PATTY MANION TO PROVIDE ASSISTANCE TO THE RESIDENTIAL HOSPICE PROGRAM AT NORTH MEMORIAL. FUNDS ARE USED TO UPGRADE THE FACILITIES AND EQUIPMENT AT THE NORTH RESIDENTIAL HOSPICE FACILITY IN BROOKLYN CENTER, PROVIDE ADDITIONAL PROGRAM SUPPORT, STAFF TRAINING AND TO ASSIST THOSE FAMILIES THAT CANNOT AFFORD THIS SERVICE. THE RESIDENTIAL HOSPICE FACILITY WAS SOLD IN 2017 AND WE ARE CURRENTLY WORKING THROUGH THE PROCESS TO REPURPOSE THE ENDOWMENT FUNDS. NO FUNDS WILL BE USED UNTIL THE PROCESS IS COMPLETE. 5) HELEN MURRAY MEMORIAL ENDOWMENT THIS ENDOWMENT WAS ESTABLISHED WITH AN IRREVOCABLE CHARITABLE REMAINDER TRUST BY JEANNE MITHUN TO RECOGNIZE THE OUTSTANDING SERVICE THAT NORTH RESIDENTIAL HOSPICE PROVIDED TO HER MOTHER (HELEN MURRAY) AND HER FAMILY. FUNDS ARE USED TO PROVDE CARE TO INDIVIDUALS UNABLE TO PAY FOR SERVICES AT THE FACILITY. 6) MEDICAL STAFF ENDOWMENT THIS ENDOWMENT WAS ESTABLISHED IN 2010 BY THE NORTH MEMORIAL MEDICAL STAFF EXECUTIVE COMMITTEE. PROCEEDS FROM THE ENDOWMENT WILL FUND NORTH MEMORIAL PROGRAMS SUCH AS JUNIOR VOLUNTEER SCHOLARSHIP, SAFEJOURNEY, PASTORAL CARE, ETC. 7) MAPLE GROVE MEDICAL STAFF ENDOWMENT WAS ESTABLISHED IN 2013 BY THE MAPLE GROVE MEDICAL STAFF EXECUTIVE COMMITTEE. PROCEEDS FROM THE ENDOWMENT WILL FUND MAPLE GROVE PROGRAMS.
PART X, LINE 2:NORTH MEMORIAL EVALUATES ITS UNCERTAIN POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2018 OR 2017.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1DINNER/DANCE GALAEvent1Nm
Gross Receipts Event1$524,482GrossReceiptsEvent1Amt
Charitable Contri Event1$355,576CharitableContriEvent1Amt
Gross Revenue Event1$168,906GrossRevenueEvent1Amt
Non Cash Prizes Event1$93,203NonCashPrizesEvent1Amt
Food And Beverage Event1$65,728FoodAndBeverageEvent1Amt
Event2GOLF FUNDRAISEREvent2Nm
Gross Receipts Event2$172,872GrossReceiptsEvent2Amt
Gross Revenue Event2$172,872GrossRevenueEvent2Amt
Food And Beverage Event2$39,108FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$15,623OtherDirectExpensesEvent2Amt
Gross Receipts Total$697,354GrossReceiptsTotalAmt
Charitable Contributions Tot$355,576CharitableContributionsTotAmt
Gross Revenue Total Events$341,778GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$93,203NonCashPrizesTotalEventsAmt
Food And Beverage Total Events$104,836FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$15,623OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$213,662DirectExpenseSummaryEventsAmt
Net Income Summary$128,116NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
NORTH MEMORIAL HEALTH CARE
3300 OAKDALE AVE NROBBINSDALEMN55422410729979501(C)(3)$124,373GRANTS IN CONNECTION WITH CANCER RELATED PROGRAMS
NORTH MEMORIAL HEALTH CARE
3300 OAKDALE AVE NROBBINSDALEMN55422410729979501(C)(3)$128,170TO SUPPORT NMHC PROGRAMS AND SERVICES
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (7 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
TEAM MEMBER ASSISTANCE/CRISIS FUND28$45,042
JUNIOR VOLUNTEER SCHOLARSHIPS11$7,000
HOSPICE FUND100$15,036
CANCER CARE PHARMACY FUND20$24,673
NURSING DEVELOPMENT FUND1$35,961
HAROLD ECKER ENDOWMENT1$7,976
ALL OTHER$5,932

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION PRIMARILY MAKES GRANTS TO RELATED ORGANIZATION NORTH MEMORIAL HEALTH CARE AND RECORDS ARE MAINTAINED AS TO HOW FUNDS ARE DISBURSED BY BOTH ORGANIZATIONS. THE ORGANIZATION ALSO FUNDS CONTINUING EDUCATION FOR NORTH MEMORIAL EMPLOYEES AND MAKES SEVERAL SMALL SPONSORSHIPS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
J KEVIN CROSTON MD
BOARD MEMBER$0$809,165$0$202,500$0$9,297$0$19,250$0$27,712$0$1,067,924$0$0
PAMELA DOORENBOS MD
BOARD MEMBER$0$300,769$0$45,115$0$400$0$16,500$0$9,001$0$371,785$0$0
DEEPAK KADEMANI DMD MD
BOARD MEMBER$0$481,724$0$199,958$0$2,858$0$19,250$0$26,341$0$730,131$0$0
KENT SPAULDING
VICE PRESIDENT$0$224,519$0$33,750$0$1,085$0$18,079$0$21,561$0$298,994$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE CHIEF EXECUTIVE OFFICER OF NORTH MEMORIAL PROVIDES SERVICES TO NORTH MEMORIAL HEALTH CARE AS WELL AS TO ALL RELATED ENTITIES AS IDENTIFIED ON SCHEDULE R. AS SUCH, HIS COMPENSATION LEVEL INCORPORATES SERVICES PROVIDED TO MULTIPLE NORTH MEMORIAL ENTITIES. THE CEO OF NORTH MEMORIAL HEALTH CARE HAS A PERMANENT SPOT ON THE BOARD OF THE NORTH MEMORIAL FOUNDATION.
PART I, LINE 6NORTH MEMORIAL HEALTH CARE'S ANNUAL INCENTIVE PLAN REQUIRES ACHIEVEMENT OF STATED PERFORMANCE METRICS, WHICH INCLUDE OPERATING CASH FLOW MARGIN.

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescAUCTION ITEMS & MISCDesc
Contribution156ContributionCnt
Noncash Contributions Rpt F990$110,786NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationTHE NUMBER IN PART I, COLUMN (B) REPRESENTS THE NUMBER OF CONTRIBUTORS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 4THE FOUNDATION CHANGED ITS BYLAWS TO INCREASE THE NUMBER OF BOARD MEMBERS. THE PREVIOUS BYLAWS STATED THAT THE BOARD WOULD HAVE NO MORE THAN 15 MEMBERS. THE AMENDED BYLAWS STATE THAT THE BOARD SHALL BE COMPRISED OF NOT LESS THAN 9 AND NOT MORE THAN 20 MEMBERS. MEMBERSHIP CAN BE INCREASED UP TO 25 MEMBERS IN SUPPORT OF A CAPITAL FUNDRAISING CAMPAIGN OR OTHER LARGE FUNDRAISING EVENT, IF APPROVED BY MAJORITY VOTE OF THE FOUNDATION BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 6NORTH MEMORIAL HEALTH CARE IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7ANORTH MEMORIAL HEALTH CARE, AS THE SOLE MEMBER OF THE ORGANIZATION, DETERMINES THE NUMBER OF BOARD MEMBERS AND ELECTS MEMBERS AT THE ANNUAL MEETING AFTER CONSIDERATION OF NOMINATIONS, IF ANY, FROM THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE APPROVAL OF NORTH MEMORIAL HEALTH CARE AS THE SOLE MEMBER OF THE ORGANIZATION IS REQUIRED FOR THE FOLLOWING ACTIONS OF THE ORGANIZATION'S GOVERNING BODY: (1) AMENDMENTS TO THE GOVERNING DOCUMENTS; (2) MERGER OR CONSOLIDATION OF THE ORGANIZATION; (3) SALE, LEASE, PLEDGE, TRANSFER, ASSIGNMENT OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION; (4) MORTGAGES OR OTHER SECURITY INTERESTS AFFECTING ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE ORGANIZATION; (5) ISSUANCE OF CAPITAL CALLS TO THE MEMBER; AND (6) DISSOLUTION AND LIQUIDATION OF THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WILL BE DISTRIBUTED TO ALL BOARD MEMBERS AT THE MEETING CLOSEST TO THE FILING DATE FOR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12CALL MEMBERS OF THE BOARD OF DIRECTORS AND ALL EMPLOYEES RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY EACH YEAR. EACH BOARD MEMBER AND STAFF MEMBER FILLS OUT A CONFLICT OF INTEREST QUESTIONNAIRE IN WHICH THEY ARE ASKED TO IDENTIFY ANY RELATIONSHIP THAT WOULD CREATE A CONFLICT OF INTEREST. THE RESULTS ARE SUMMARIZED AND REVIEWED TO DETERMINE ANY ACTUAL OR POTENTIAL CONFLICT AND ARE REPORTED TO THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION'S OFFICERS RECEIVED THEIR COMPENSATION FROM NORTH MEMORIAL HEALTH CARE (NMHC) WHICH FOLLOWS NMHC'S POLICIES AND PROCEDURES ON DETERMINING COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:NET CHANGE IN INTEREST IN BENEFICIAL TRUST -286,627.
FORM 990, PART XII, LINE 2C:NEITHER THE OVERSIGHT OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANT CHANGED DURING THE TAX YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
NORTH MEMORIAL HEALTH CARE
3300 OAKDALE AVE NROBBINSDALEMN55422410729979ACUTE CAREMN501(C)(3)LINE 3NORTH MEMORIAL0
ASSOCIATED HEALTH ASSURANCE
3300 OAKDALE AVE NROBBINSDALEMN55422980343815INSURANCE501(C)(3)11ANORTH MEMORIAL0BD
MAPLE GROVE HOSPITAL CORPORATION
3300 OAKDALE AVE NROBBINSDALEMN55422208316475ACUTE CAREMN501(C)(3)LINE 3NORTH MEMORIAL0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE LLC
9855 HOSPITAL DRIVEMAPLE GROVEMN55369260393039OUTPATIENT SURGERYMNN/A
MINNESOTA DIAGNOSTIC IMAGING PARTNERS LLC
2955 XENIUM LANE SUITE 40PLYMOUTHMN55441352162215RADIOLOGYMNN/A
NORTH RADIATION THERAPY CENTER LLC
6950 FRANCE AVE S SUITE 200EDINAMN55435743069974RADIOLOGYMNN/A
MINNETONKA AMBULATORY SURGERY CENTER
3300 OAKDALE AVENUE NORTHROBBINSDALEMN55422465653486OUTPATIENT SURGERYMNN/A
MULTICARE SLEEP CENTER LLC
10600 OLD COUNTY ROAD 15PLYMOUTHMN55441274833673OUTPATIENT SLEEP CENTERMNN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
OAKDALE HEALTH ENTERPRISES INC
3300 OAKDALE AVE NROBBINSDALEMN55422411546422AMBULANCEMNN/AC0
CHARITABLE REMAINDER TRUST (1)
CHARITABLE TRUSTMNN/AT0
NORTH COLLABORATIVE CARE
3300 OAKDALE AVE NROBBINSDALEMN55422461680666PRIMARY CAREMNN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1NORTH MEMORIAL HEALTH CARE (CONTRIBUTIONS TO NMHC)BusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeBTransactionTypeTxt
Involved$252,543InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt

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